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My Mom is 86 and has dementia. She was in the hospital 3 weeks ago and she has been in bed at home since then. She is on a puree diet, in diapers and is so frail. She always had edema in her legs, now her legs are so skinny and she is really shaky when trying to stand. She has been in the hospital several times and always bounced back within two weeks, but this time, she is just laying in bed and does not seem interested in anything. I took her out in a wheelchair this weekend to get some sun, and she didn't seem interested at all. How can I get her to walk and get out of bed? She is shrinking away in front of my eyes and it's killing me.

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Your Mom may be "done with all this" and you need to honor her if that is how she feels. You cannot know it now, but as a retired RN and an 80 year old woman I can promise you that you WILL know in the future that we get tired. Old age is a low drip of taking everything from us, our hair, our eyes and ears, our balance and mobility, our continence, our control, our joy in food or in anything else, and eventually it takes our minds. Many are ready to exit before more torment as there is no upside to it at all.
Please do Mom the honor of listening to how she feels. Don't negate her feelings of being ready to exit if that's how she feels, because that leaves her to be able to be honest only with her nurses. That was me for my entire career and I cannot tell you how often I tried to make families see that some are ready to leave. My own Dad was ready and able to express that to me, to discuss how he had loved his life, and the few things he felt bad he had done.
Let Mom speak. This is about her. You will grieve and you will move on, as this is what happens to all of us. Hopefully you will ALSO celebrate her long life. For now, stop pushing her and adding to her pain. I am pretty much begging you. Ask her honestly what she wants. If it is Hospice then see to it that happens. You will be proud of yourself and without regret if you honor what your Mother wants now.
Gently reposition your Mom. If you get Hospice in they will teach you how to prevent skin breakdown and help her circulation. But know that the end comes to us all. It is either more or less welcomed by us, and by our families, but it is inevitable.
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She may not be able to move like you would like her to. And may not ever. It's hard to say with what you have described, but I can tell you that after my husband who had vascular dementia was in the hospital for 3 weeks and then the hospice home for 1 week, he came home completely bedridden where he remained for the last 22 months of his life, and was never able to walk again.
You may want to check with your moms doctor to see if they think having some in-home PT might help build up her strength, but with her being so frail, I'm sure she is now a fall risk, so you really have to weigh the pros and cons of having her try and walk again.
There are no easy answers here. It may be time to bring hospice on board, as they will help keep her comfortable and will supply all needed equipment(like hospital bed)supplies(diapers, pads creams etc.)and medications, all covered 100% under moms Medicare. They will also have a nurse to come out once a week to start and aides to come twice a week to bathe her in bed if needed. And just because hospice comes on board doesn't mean that your mom will be dead soon. My husband was under their care in our home for the last 22 months of his life.
The bottom line is that you want your mom to be as comfortable as possible for however long she has on this earth, so I wish you the very best in deciding exactly what that looks like for her.
God bless you.
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You can't assume she doesn't want to do anything. What does her doctor say?

Maybe she needs to be on hospice now. Maybe this time around she won't bounce back, or maybe it'll take longer this time. You need to talk to a doctor.

Nature decides what's going to happen, and she doesn't care whether it's killing you or not. It just may be her time.
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Has she been able to stand assisted or unassisted? The longer the legs are not used the more likely they will not be able to provide support. This November it will be two years since my mother walked or even stood. A septic infection in AL brought her to the hospital. No amount of therapy ever made her able to support herself again and I believe she really wanted to. She became too weak and maybe the brain couldn't fire to use her legs. Her legs are totally atrophied. I did get a pedaler and got her to pedal her legs. Then she was dropped and both her femurs were broken. That was the end of mobility for her.

Maybe she is tired of life and what it demands of her. Our wishes don't always match. Does she communicate about movement she would like to try?
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Has the doctor prescribed Occupational Therapy for her at home? Maybe you should take her back to the doctor so he can evaluate her present condition.
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You might be at that point with the next hospitalization to tell the case workers that she will need LTC on Medicaid and they will help with the paperwork. Otherwise, you can also get a hospice consult. She might be shutting down. Your timing whether to keep her at home will be up to you since she will no longer be treated in the hospital.
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